Effects of Acute Aerobic Exercise Versus Acute Zolpidem Intake on Sleep in Individuals with Chronic Insomnia

Introduction Sleeping pills are assumed to be the most efficacious means of treating acute insomnia, but their use has associated risks. Exercise could provide a healthy alternative treatment for insomnia, particularly if it could be shown to have comparable efficacy to sleeping pills. Objective The purpose of this study was to compare the effects of acute exercise versus zolpidem on chronic insomnia. Methods Seventeen participants with chronic insomnia (recruited from advertisements) participated in a parallel randomized controlled trial (exercise, n = 9; zolpidem, n = 8). Participants in the exercise treatment performed treadmill exercise for 50 minutes, at 50% of heart rate reserve, between 11 AM and 2 PM. Participants in the zolpidem treatment received a 10 mg dose of zolpidem immediately before bedtime. Following baseline and following the treatment, sleep measures included sleep diary, polysomnography, and actigraphy. Treatments were compared with non-inferiority analysis, ANOVA, and effect sizes. Results Non-inferiority of exercise relative to zolpidem was observed for polysomnographic measurement of sleep latency. For all other comparisons, the non-inferiority was inconclusive. Significant treatment-by-time interactions were observed for N3 sleep (p = 0.04) and REM sleep (p = 0.03). No other significant treatment-by-time effects were observed. Subjective sleep duration and sleep efficiency, and polysomnographic measurement of sleep efficiency were significantly increased after zolpidem and exercise. The effect size between groups was small for these variables. Conclusion Exercise impacted sleep in a similar way to zolpidem in participants with chronic insomnia. Considering the far superior health benefits of exercise, further research addressing this question is warranted.